Active NPI
Mark D. Goodman, M.D.
- Family Medicine Physician
- Omaha, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 17235
- Practice address
- 1319 Leavenworth St
Omaha, NE 68102-3215 - Phone
- (402) 717-0420
- Fax
- (402) 717-6042
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17235 | NE | Primary |
Addresses
Primary practice location
1319 Leavenworth St
Omaha, NE 68102-3215
Mailing address
7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6254
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Nebraska College of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16909 Lakeside Hills CT
Omaha, NE 68130-4661
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Family Medicine | Current | Accepting new patients |
| CHI Health Clinic Physician Enterprise-Anesthesia LLC | Past | Accepting new patients | |
| Creighton University | Family Medicine | Past | Accepting new patients |
| Alegent Creighton Clinic | Family Medicine | Past | Accepting new patients |
| Alegent Creighton Health | Past | Accepting new patients | |
| Creighton University | Past | Accepting new patients |
Locations
2771 Solution Ctr
Chicago, IL 60677
1319 Leavenworth St
Omaha, NE 68102
Phone (402) 552-2050
7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248
7710 Mercy Rd
Ste 426
Omaha, NE 68124
Phone (402) 343-8650
7909 N 30th St
Omaha, NE 68112
Phone (402) 280-4780
16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920
2412 Cuming St
Ste 200
Omaha, NE 68131
Phone (402) 717-0380
Interoperability endpoints
- mgoodman45782@achce.catholichealth.net
- mark.goodman.1@23757.direct.athenahealth.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Omaha, NE
- NPI 1548287907
-
- Community/Retail Pharmacy
- Lincoln, NE
- NPI 1598423220
-
- Anesthesiology Physician
- Omaha, NE
- NPI 1356858419
-
- Allergy & Immunology (Internal Medicine) Physician
- Omaha, NE
- NPI 1295777225
Family Medicine
-
- Physical Therapist
- Omaha, NE
- NPI 1780172304
-
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1598811069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478649600000",
"number": "1326157124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7261 MERCY RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681242311",
"telephone_number": "402-398-6254",
"fax_number": "402-829-8513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 LEAVENWORTH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681023215",
"telephone_number": "402-717-0420",
"fax_number": "402-717-6042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "MARK",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2016-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "17235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.